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頁籤選單縮合
題名 | Renal Replacement Therapy in the Neonatal Period=新生兒期之腎臟替代療法 |
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作者姓名(中文) | 張瑞幸; 蔡淳娟; 洪漢陽; 林炫沛; 黃富源; 高信安; 許瓊心; | 書刊名 | Clinical Neonatology |
卷期 | 4:1 1997.01[民86.01] |
頁次 | 頁16-21 |
分類號 | 417.517 |
關鍵詞 | 新生兒; 腎臟替代療法; Neonate; Dialysis; Hemofiltration; Renal failure; Hyperammonemia; |
語文 | 英文(English) |
英文摘要 | We retrospectively reviewed the course of 12 neonates who received renal replacement therapy at Mackay Memorial Hospital between January 1988 and June 1996. The dialysis modalities included acute perioneal dialysis (PD) in nine cases, continuous arteriovenous hemofiltration (CAVH) in two cases, and continuous arteriovenous hemodiafiltration (CAVHD) in one case. The mean birth weight was 2,803 g (range 1,020-3,810 g) with mean 3-31 days), and the mean body weight was 2,945 g (range 1,050-4,490 g). The underlying diseases were sepsis in six cases, inborn errors of metabolism in four cases, asphyxia in one cases, and bilateral renal hypoplasis in one case. the indications for renal replacement therapy were acute renal failure with intractable fluid overload, hyponatremia, hyperkalemia and acidosis in eight patients and hyperammonemia cased by inborn errors of metabolism in four patients. Effective dialysis, defined by the reversal of the above metabolic disturbance or achievement of fluid balance, was accomplished in eight patients (67%). No complications of perionitis, or metaboic disturbance were related to the dialysis therapy. Major bleeding from arterial catheterization site, necessitating blood transfusion, occurred in one patient with CAVH and one patient with CAVHD. The mortality rate was 62.5% in patients with renal failure, and 25% in those with hyperammonemia. Our study showed that peritoneal dialysis is an effective and safe dislysis modality in neonates. Because of vascular access difficulty, coagulation problems and cost ineffectiveness, CAVH and CAVHD are only indicated in cases with restricted indications. Severe underlying disease was the major cause of death in this group of patients. (Clinical Neonatology 1997;4:16-21) ons. Severe underlying disease was the major cause of death in this group of patients. |
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